Occupational asthma

Last reviewed: 7 Jun 2022
Last updated: 11 Jan 2022

Summary

Definition

History and exam

Key diagnostic factors

  • occupational exposure to sensitizing agents or irritants
  • symptoms of asthma that improve during holidays
  • initial onset of asthma symptoms during a work period
More key diagnostic factors

Risk factors

  • high-level exposure to sensitizer
  • atopy
  • genetic factors
  • smoking
More risk factors

Diagnostic investigations

1st investigations to order

  • spirometry (pre- and post-bronchodilator)
  • chest x-ray
  • skin prick testing
  • specific serum IgE assay
  • nonspecific bronchial provocation testing
  • serial peak expiratory flow rate
More 1st investigations to order

Investigations to consider

  • specific inhalation challenge
More investigations to consider

Emerging tests

  • induced sputum cytology
  • exhaled nitric oxide

Treatment algorithm

ACUTE

sensitizer-induced

irritant-induced

ONGOING

symptomatic asthma

Contributors

Authors

Ryan Hoy, MB BS, MOEH, FRACP
Ryan Hoy

Respiratory Physician

The Alfred Hospital

Melbourne

Victoria

Australia

Disclosures

RH declares that he has no competing interests.

Susan M. Tarlo, MB BS FRCP(C)
Susan M. Tarlo

Professor of Medicine

University of Toronto

Respiratory Physician

Toronto Western Hospital

Toronto

Ontario

Canada

Disclosures

SMT declares that she has no competing interests.

Peer reviewers

Ware Kuschner, MD

Associate Professor of Medicine

Stanford University

Stanford

Staff Physician

US Department of Veterans Affairs

Palo Alto Health Care System

Palo Alto

CA

Disclosures

WK declares that he has no competing interests.

Karin Pacheco, MD

Associate Professor of Medicine

National Jewish Medical Centre

Denver

CO

Disclosures

KP declares that she has no competing interests.

Philip Harber, MD

Professor of Medicine

University of California

Los Angeles

CA

Disclosures

PH declares that he has no competing interests.

  • Occupational asthma images
  • Differentials

    • Work-exacerbated asthma
    • Occupational eosinophilic bronchitis
    • Coincidental nonoccupational asthma
    More Differentials
  • Guidelines

    • Global strategy for asthma management and prevention
    • Japanese guidelines for occupational allergic diseases 2020
    More Guidelines
  • Patient leaflets

    Asthma in adults

    More Patient leaflets
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